雷美替胺(Ramelteon)怎么购买

Ramelteon is a highly selective melatonin receptor agonist. It is a prescription drug and must be used with a physician's prescription.

The correct purchasing channel for Ramelteon

1. Hospital pharmacy

After visiting the neurology department, psychiatric department or sleep clinic of the hospital, the prescription issued by the doctor can be prepared and purchased directly at the hospital pharmacy.

2. Regular retail pharmacies

With a valid prescription issued by a doctor, you can also purchase it at major regular chain or independent pharmacies. The pharmacist will review the prescription and may provide additional medication instructions.

3. Online drug purchase platform

Some qualified online pharmacies also provide prescription drug purchase services. The process usually involves uploading or mailing prescriptions, which will be shipped after being reviewed by the platform. Be wary of any sales channels that do not require a prescription to prevent the purchase of fake and substandard drugs.

The pictures are from public channels (such as the official website of the FDA, the official website of the original drug manufacturer, etc.) and are for reference only.

Absolute contraindications of Ramelteon

1. People allergic to Ramelteon or any ingredients

If you are known to be allergic to Ramelteon or its excipients (such as lactose), use is strictly prohibited. If allergic symptoms such as rash, itching, difficulty breathing, angioedema (such as swelling of lips, eyelids, and tongue) occur after taking the medication, you need to stop taking the medication immediately and seek medical treatment, and you must not use it again in the future.

2. Those who are taking fluvoxamine

Fluvoxamine is a powerful CYP1A2 enzyme inhibitor. Its combined use with ramelteon will increase the blood concentration of ramelteon hundreds of times in the body, which may lead to extremely serious and unknown side effects. Therefore, combined use is absolutely prohibited.

3. Patients with severe hepatic insufficiency

Ramelteon is mainly metabolized by the liver. For patients with severe (Child-Pugh grade C) liver damage, the exposure of the drug in the body will increase more than ten times, greatly increasing the risk of poisoning, so its use is not recommended.

Drug interactions of Ramelteon

1. Substances that are absolutely prohibited from being used together

Alcohol: Both alcohol and Ramelteon depress the central nervous system. The combined use of the two will produce additive effects, significantly aggravating drowsiness, dizziness, decreased judgment and motor coordination impairment, and greatly increasing the risk of "complex sleep behaviors" (such as sleepwalking driving) and accidental injuries. You must avoid drinking alcohol while taking this medication.

2. Drugs that need to be combined with caution or closely monitored

The following drugs will affect the metabolism of ramelteon to varying degrees. Extra caution should be exercised when used together, and reactions should be closely observed under the guidance of a doctor:

(1) Strong CYP enzyme inducers: such as rifampicin (anti-tuberculosis drug). This type of drug will accelerate the metabolism and clearance of ramelteon, which may cause its blood concentration to drop significantly, weakening or even ineffective the hypnotic effect.

(2) CYP1A2 inhibitors: In addition to fluvoxamine, which is absolutely contraindicated, other weaker CYP1A2 inhibitors (such as certain antibiotics) also need to be used with caution.

(3) CYP3A4 inhibitors: such as ketoconazole and itraconazole (antifungal drugs), will increase the concentration of ramelteon.

(4) CYP2C9 inhibitors: such as fluconazole (antifungal drug), will also increase the exposure of ramelteon.

3. Synergy with other central nervous system depressants

Combined use with other sedative-hypnotics, anxiolytics, opioid analgesics, anti-epileptic drugs and certain antihistamines (anti-allergy) will produce similar synergistic inhibitory effects and aggravate central depression. If used together, it must be done under close supervision by a doctor and the dosage must be adjusted.